产前超声诊断胎儿消化道闭锁

Prenatal diagnosis of fetal digestive tract atresia with ultrasound

目的探讨产前超声诊断胎儿消化道闭锁的临床价值。方法回顾性分析22胎消化道闭锁胎儿的产前超声图像及尸体解剖资料。结果 22胎产后尸体解剖共发现24处消化道闭锁(2胎同时合并食管及肛门闭锁),产前超声检出食管闭锁3处、十二指肠闭锁4处、空回肠闭锁3处、肛门闭锁3处,检出率为54.17%;漏诊食管闭锁4处、幽门闭锁1处、肛门闭锁6处。结论产前超声诊断胎儿消化道闭锁方法简便,加强动态观察尤其是晚孕期复查与全面系统检查可减少漏诊。

Objective To assess the clinical value of prenatal ultrasound in diagnosing fetal digestive tract atresia. Methods Prenatal ultrasound images and anatomic characteristics of 22 fetuses with digestive tract atresia were retrospectively analyzed. Results Twenty-four digestive tract atresia in 22 fetuses （2 fetuses with esophagus and anal atresia simultaneously） were proved with autopsy,whereas 3 esophagus atresia,4 duodenal atresia,3 jejunal-iliac atresia and 3 anal atresia were detected with prenatal ultrasound,and the ultrasonic detectable rate was 54.17%. Four esophagus atresia,1 pyloric atresia and 6 anal atresia were not diagnosed with prenatal ultrasound. Conclusion Prenatal ultrasound is a convenient method to diagnose fetal digestive tract atresia. Dynamic examination,especially in third trimester and systemic observation are helpful to reduce misdiagnosis.